The Cecil G. Sheps Center for Health Services Research of the University of North Carolina at Chapel Hill requests two additional years of support for its Exploratory (P-20) Center on the Health and Effective Functioning of Older Rural Populations. In its initial three-year period the NC * Rural Aging Program undertook to study the social, economic, psychological, environmental and biomedical factors affecting the aging processes and the health and effective functioning of older people living in rural areas as it sought to address four broad areas of topical concern: * The changing sociodemographic and epidemiological characteristics of older rural populations. * The population-aging of rural communities. * The availability, utility and quality of healthcare and other services in rural areas. * Rural areas and older people as a resource. In the proposed two-year extension of the present P-20 center funding, we propose to further consolidate our efforts in two community-based laboratory settings (in rural Johnston and Northampton Counties in North Carolina), add additional research activities in these sites, launch new research activities unrelated to these laboratory sites, and link the research taking place under the umbrella of the P-20 exploratory center program with a series of on-going projects where subsets of research issues and data sets intersect with the foci of the small-scale exploratory studies to be launched during the proposed two-year period of extended support. These projects will take place in two broad thematic areas: * Studies of the influence of rural social and cultural context on health perceptions and behaviors. * Studies of the clinical, social and economic impact of limited access to health care services on rural communities. Throughout the additional two-year period of funding requested in this proposal we will continue to publish three times per year our newsletter, NC.RAP.Line, as a supplement to the North Carolina Rural Gazette, a regular publication of the North Carolina Program on Rural Health Research. Annually throughout the additional two-year period of support we will convene our External AdvisOry Committee, as we have done on one occasion this past (02) year. The internal Research Program Advisory Board will continue to function as the internal steering committee for the overall P-20 grant-supported activities.